Care Coordinator

Job summary

The SS9 Integrated Neighbourhood team has an opportunity for a care coordinator to join our us on a part-time basis for 22.5 hours per week, or 37.5 hour per week in conjunction with the Integrated Neighbourhood HCA role we are also advertising.

The post-holder will provide extra time, capacity and expertise to our practice team to help us to improve the care provided to our patients.

If you are a skilled care co-ordinator, with excellent person-centred planning experience and strong local knowledge for accessing key support, then we would love to hear from you.

Main duties of the job

• Work closely with the INT / PACT matron to coordinate care that enables individuals to remain at home, maintain independence, and avoid unnecessary admission to hospital.
• Support service transformation by building strong relationships with primary care, secondary care, tertiary care, and voluntary sector colleagues.
• Liaise with patients, families, and carers to ensure care plans are individualised, holistic, and supporting independence.
• Operate within an interprofessional team- working alongside social care, community health, NHS services, and local voluntary organisations.
• Promote and utilise technology to improve communication, care coordination, and monitoring of patient progress.
• Assist in safe hospital discharges by arranging follow-up care, welfare calls, and referrals to relevant health or community services.
• Collaborate with the interprofessional team to develop, monitor, and update personalised care plans.
• Connect patients with appropriate community resources, services, and clinical pathways (e.g., pharmacists for medication reviews, health coaches for lifestyle support, social prescribing link workers).
• Schedule and coordinate appointments with healthcare professionals and support services as required.
• Respond to queries from patients and families, escalating appropriately where additional clinical or specialist input is required.
• Be flexible to travel within the locality and work remotely when needed (a full UK driving licence is desirable).

About us

The Integrated Neighbourhood Team (INT) operates across both SS9 North and SS9 South Primary Care Networks (PCNs), providing essential support to patients who are housebound or transitioning from hospital care back into the community. The teams primary aim is to deliver person-centred care in a timely and coordinated manner, helping individuals remain safely at home, optimise their independence, and reduce the likelihood of unnecessary hospital readmissions.

The INT is a multidisciplinary team made up of professionals from Primary Care, Secondary Care, Tertiary Care, Social Care, and the Voluntary Sector. This includes GPs, nurses, emergency care practitioners, social prescribers, and allied health professionals. By working collaboratively, the team delivers integrated care, welfare checks, and personalised support tailored to each patients unique needs.

Joining the INT means becoming part of a wider community committed to innovation, teamwork, and delivering high-quality, patient-centred care.

Employee Benefits:

• NHS Pension Scheme
• Minimum 25 days annual leave (FTE)
• Supportive, multi-disciplinary team environment
• Ongoing training and development opportunities

If you are passionate about supporting patients through care transitions and want to be part of a dynamic and forward-thinking team, we would love to hear from you. Please contact, ellie.white2@nhs.net, for more information.